Healthcare Provider Details

I. General information

NPI: 1326657156
Provider Name (Legal Business Name): TWIN CITIES SENIOR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14901 WEAVER LAKE RD N
MAPLE GROVE MN
55311-7538
US

IV. Provider business mailing address

14901 WEAVER LAKE RD N
MAPLE GROVE MN
55311-7538
US

V. Phone/Fax

Practice location:
  • Phone: 763-415-3900
  • Fax: 763-415-3909
Mailing address:
  • Phone: 763-415-3900
  • Fax: 763-415-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: IOANA CRISTINA CHILDS
Title or Position: OWNER/HOUSING DIRECTOR
Credential:
Phone: 763-415-3901